Transforming children and young people’s mental health services: taking one step forward and two steps back

In this blog Dr Terry Hanley, Senior Lecturer in Counselling Psychology and Dr Laura Anne Winter Lecturer in Education and Counselling Psychology both from The University of Manchester set out their response to the Government’s Green Paper on children and young people’s mental health. The Green Paper focuses on earlier intervention and prevention in schools and colleges. Dr Terry Hanley explains that while it is well meaning it ignores recent recommendations and the lack of progress in the document has led to a one step forward, two steps back situation.

In the recent years, several recommendation documents have been published by the Departments of Education and Health that demonstrate a significant change in attitude – but constant revision has led to them becoming watered down.

My research has shown that the impact of the current socio-political climate means that resources for professionals in schools to support the emotional wellbeing of young people are becoming scarcer.

Schools report having to make difficult decisions about how they distribute resources, for instance, should they employ an educational psychologist or fund a lollipop person.

Teachers told us that they believe that they increasingly have to deal with more serious issues and feel that they are not fully equipped to do this. Issues such as these, alongside the mismatch between Government requirements for schools and the need to respond to high levels of need, create great stresses for those working schools and prove hugely concerning.

a new mental health workforce of community-based mental health support teams will be created

every school and college will be encouraged to appoint a designated lead for mental health

a new 4-week waiting time for NHS children and young people’s mental health services will be piloted in some areas

Once again, this all sounds great. The problem here, for us, is that all of the talking does not seem to have manifested in walking the walk, with the current proposal ignoring recent recommendations and ignoring many fundamental issues. It just isn’t good enough and although there are signs of progress in the document (one step forward), it seems to be snatching away the hard work and promise evident in other recommendations (two steps back). We therefore recommend that people get involved and contribute to the debate at the end of this brief post.

Previous Recommendations

To start, it is important to flag up some recent context. In the recent years, several recommendation documents have been published by the Department’s of Education and Health that demonstrate a significant change in attitude. For instance, the Future in Mind report highlighted how schools can act as hubs for developing accessible services for mental health support and the Counselling in Schools: a blueprint for the future noted it to be the authors’ expectations that “all schools should make counselling available to their pupils”. These reports, alongside others, started to indicate that there was a true commitment towards meaningful change, something that, to use the term within the recent Green Paper might truly ‘transform’ mental health services for this age group. The documents acknowledge the hugely complex arena and highlight the need for skilled professionals working in both targeted and universal ways. Given this thrust of energy, it was therefore a surprise to see that the fruits of all of this labour had been diluted down to the point that, if it were Ribena, it would be rejected by the children that it was offered to due to its substandard, tokenistic and ineffective end result. In fact, when it comes to the recommendation about having counsellors in school, this has just been omitted completely.

Secondly, we would highlight that the headlines themselves prove problematic. The Children’s Society outlines a thoughtful response to each of these in turn. A crude summary would be that they:

1) Highlight the need to know more about how to refer into community-based mental health support teams and to question why school-based counselling hasn’t been recommended as a statutory provision

2) Highlight that many schools already have mental health leads

3) Acknowledge that a four week waiting time is a good aim on paper, but might lead to perverse practices that focus upon throughput of services rather than quality interventions. The Children’s Society doesn’t say this, but the recommendations seem to be out of touch with real world practices and amazingly lacking in substance.

Our Research

Our own research into the impact of the current socio-political climate upon the way that professionals in schools support the emotional wellbeing of young people can also contribute to this debate. In our research we highlight numerous challenges that are presently faced by schools and the professionals working in them.

The findings note that a wide array of professionals are already supporting young people’s emotional wellbeing, but there is the perception that resources are becoming scarcer – particularly the access to mental health professionals. Schools report having to make difficult decisions about how they distribute resources, for instance, should they employ an educational psychologist or fund a lollipop person. Teachers told us that they believe that they increasingly have to deal with more serious issues and feel that they are not fully equipped to deal with these issues. Issues such as these, alongside the mismatch between Government requirements for schools (as assessed through Ofsted) and the need to respond to high levels of need (which are also noted in the Green paper), create great stresses for those working schools and prove hugely concerning.

With this in mind, any resources in schools need to be accompanied by a strategy that responds to the many layers involved in an effective response. This should:

1) Be political – it needs to acknowledge that schools will have to be evaluated on more than just academic attainment

2) Be influenced from the senior leaders – the management in schools should be mindful of the impact of this type of work on staff members and ensure safeguards such as supportive supervision and training are available to staff

3) Be reflective in nature – for schools to share good practices through networks that acknowledge the financial limitations available to them

4) Be supportive of the supporters – staff members themselves need to be mindful of the impacts of school based emotional labour and take care of themselves through supportive activities. We realise that this is a big undertaking, and possibly a shift in culture for some, but that is the point. A few headline activities will not lead to the development of sustainable framework that incorporates mental health support into educational settings.

However, these are not just our views. Mental health organisations, such as The British Association of Counselling and Psychotherapy (BACP), in conjunction with other mental health organisations, flag up similar issues. This is a great opportunity to transform services for children and young people, let’s not waste it.

So what can you do about this?

The consultation about the Green paper is presently up and running. We would therefore suggest that you might want to contribute to the debate. The consultation information can be found here. Additionally, the BACP have also developed a very simple form that can be completed to inform local MPs about this issue. This takes no longer than a few minutes to complete and can be found here.

About Terry Hanley

Dr Terry Hanley is the Interim Director of Social Responsibility for SEED. He is also the Programme Director of the Doctorate in Counselling Psychology within the Manchester Institute of Education. He regularly presents at national and international coferences and is an international academic advisor for the Masters programme in Counselling at the Moscow School of Economic and Social Sciences and Programme External Examiner for the Doctorate in Counselling Psychology at Trinity College Dublin.

About Laura Winter

Laura Winter is a HCPC Registered Counselling Psychologist and Lecturer in Education and Counselling Psychology at the University of Manchester. Her research explores the interrelationships between inequality, emotional wellbeing and educational experience and outcomes.

Comments

Thanks both for this. A reminder of the importance of investing in the right thing, not just announcing investment and letting it go to waste by putting yet more expectations on teachers.
Happy to discus with you actions we can take .